本文選題：TDP + 原發(fā)性痛經(jīng)��； 參考：《北京中醫(yī)藥大學(xué)》2014年碩士論文

【摘要】：研究目的 通過對(duì)中國(guó)中醫(yī)科學(xué)院望京醫(yī)院針灸科及婦科門診原發(fā)性痛經(jīng)病人進(jìn)行臨床觀察,驗(yàn)證針刺配合TDP照射治療原發(fā)性痛經(jīng)的優(yōu)效性、安全性、簡(jiǎn)便性,為臨床進(jìn)一步推廣此治療方法提供依據(jù)。 研究方法 1.文獻(xiàn)研究 通過中醫(yī)、西醫(yī)對(duì)原發(fā)性痛經(jīng)的病因病機(jī)、診斷、治療等多方面的詳細(xì)論述,并闡述了針刺結(jié)合TDP照射在鎮(zhèn)痛及治療原發(fā)性痛經(jīng)方面的部分作用機(jī)制。 2.臨床研究 將符合納入標(biāo)準(zhǔn)和除外排除標(biāo)準(zhǔn)的60例患者隨機(jī)分為2組：治療組和對(duì)照組,按1：1的比例隨機(jī)分配 治療組：針刺結(jié)合TDP照射治療,取穴以氣海、關(guān)元、中極、天樞(雙)、子宮(雙)、血海(雙)、足三里(雙)、三陰交(雙)、丘墟透照海(雙)為主穴,結(jié)合辨證取穴氣滯血瘀加太沖、腎氣虧損加太溪,平補(bǔ)平瀉,以得氣為度,針刺留針30min,留針時(shí)同時(shí)配合TDP燈照射患者小腹,以患者感覺溫?zé)崾孢m為宜,患者于月經(jīng)來潮前半個(gè)月進(jìn)行治療,隔日治療一次,七次為一個(gè)療程,連續(xù)治療三個(gè)月經(jīng)期。對(duì)照組：服用芬必得藥物治療,患者于每次月經(jīng)前2-3天開始口服芬必得,每次0.3g,每日兩次,疼痛消失時(shí)停止,連續(xù)口服治療3個(gè)月經(jīng)周期。在患者治療前、治療三個(gè)療程后及治療結(jié)束3個(gè)月后分別進(jìn)行療效評(píng)價(jià),采用組間對(duì)比、組內(nèi)對(duì)比的方法對(duì)即使療效、近期療效、遠(yuǎn)期療效進(jìn)行評(píng)價(jià)。 3.研究結(jié)果 治療組和對(duì)照組在治療開始前采用均衡比較的方法,結(jié)果表明：兩組患者在年齡、初潮年齡、病程、痛經(jīng)癥狀積分及VAS評(píng)分、病情程度的差異均無統(tǒng)計(jì)學(xué)意義(P0.05),表示兩組之間具有可比性。 療效比較：兩組經(jīng)過治療后,治療組和對(duì)照組的即時(shí)療效總有效率為93.33%和83.33%,經(jīng)統(tǒng)計(jì)分析,兩組具有顯著差異(P0.05)；兩組近期療效對(duì)比治療組和對(duì)照組愈顯率分別為83.33%和60.00%,總有效率分別為96.67%和86.67%,經(jīng)統(tǒng)計(jì)分析,兩組具有顯著統(tǒng)計(jì)學(xué)差異(P0.05)；兩組遠(yuǎn)期療效進(jìn)行對(duì)比愈顯率分別為76.67%和40.00%,總有效率分別為93.33%和80.00%,經(jīng)統(tǒng)計(jì)分析,兩組具有顯著性統(tǒng)計(jì)學(xué)差異(P0.05)。說明本課題所選方法在即時(shí)療效、近期療效、遠(yuǎn)期療效方面明顯優(yōu)于對(duì)照組。將兩組治療前后及隨訪的痛經(jīng)癥狀積分和VAS評(píng)分進(jìn)行對(duì)比,P0.05,說明治療前后比較結(jié)果具有統(tǒng)計(jì)學(xué)差異,說明這兩種方法在治療原發(fā)性痛經(jīng)方面具有確切的療效。綜合影響因素后分析：患者病程越短,病情越輕,配合度越高,患者所取得的療效就越好。 結(jié)論： 針刺結(jié)合TDP照射治療原發(fā)性痛經(jīng)有確切的臨床療效,具有即時(shí)效果好,近期療效和遠(yuǎn)期療效優(yōu)良,臨床不良反應(yīng)少,患者容易接受等許多的優(yōu)點(diǎn),此方法值得在臨床中推廣應(yīng)用。
[Abstract]:Research purpose Through clinical observation of primary dysmenorrhea patients in Department of Acupuncture and Gynecology, Wangjing Hospital, Chinese Academy of traditional Chinese Medicine, the efficacy, safety and simplicity of acupuncture combined with TDP irradiation in the treatment of primary dysmenorrhea were verified. It provides the basis for further popularizing this method in clinic. Research method 1. Literature research The etiology, pathogenesis, diagnosis and treatment of primary dysmenorrhea were discussed in detail by traditional Chinese medicine and western medicine, and the mechanism of acupuncture combined with TDP irradiation in analgesia and treatment of primary dysmenorrhea was expounded. 2. Clinical research 60 patients who met the inclusion criteria and exclusion criteria were randomly divided into two groups: the treatment group and the control group, randomly allocated according to the 1:1 ratio. Treatment group: acupuncture combined with TDP irradiation treatment, taking points to Qihai, Guanyuan, the middle pole, Tianshu (Shuangzao, uterus (Shuangli), Xuehai (Shuangzhu, Zusanli (Shuangzhuo, Qiuxuzhaohai (Shuang) points), Combined with syndrome differentiation, point Qi stagnation and blood stasis plus Taochong, deficiency of kidney qi plus Taixi, flat tonifying and purging, acupuncture for 30 mins, combined with TDP lamp to irradiate the lower abdomen of the patient, it is appropriate for the patient to feel warm and comfortable. The patient was treated half a month before menstruation, once every other day, seven times as a course of treatment for three consecutive months. In the control group, the patients were treated with fenpiride 2-3 days before menorrhagia, 0.3 g per time, twice a day, and stopped when the pain disappeared. The patients were given oral treatment for 3 consecutive menstrual cycles. Before treatment, after three courses of treatment and 3 months after the end of the treatment, the curative effect was evaluated by the methods of inter-group and intra-group comparison, even if the curative effect, the short-term effect, and the long-term effect were evaluated. 3. Research results The patients in the treatment group and the control group were treated with balanced comparison before treatment. The results showed that: age, menarche age, course of disease, score of dysmenorrhea symptom and VAS score were used in the two groups. There was no significant difference in the severity of the disease between the two groups (P 0.05), indicating that there was comparability between the two groups. Comparison of curative effects: after treatment, the total effective rates of the treatment group and the control group were 93.33% and 83.33%, respectively. There was significant difference between the two groups (P 0.05), the effective rates of treatment group and control group were 83.33% and 60.005%, respectively, the total effective rates were 96.67% and 86.67%, respectively. There was significant statistical difference between the two groups (P 0.05), and the effective rates of the two groups were 76.67% and 40.000.The total effective rates were 93.33% and 80.000.The statistical analysis showed that the two groups had significant statistical difference (P 0.05). The results showed that the method was superior to the control group in immediate effect, short-term effect and long-term effect. The scores of dysmenorrhea symptoms and VAS scores of the two groups were compared before and after treatment and followed up (P0.05). The results showed that there was statistical difference between the two groups before and after treatment, which indicated that the two methods had definite curative effect in the treatment of primary dysmenorrhea. Comprehensive analysis of influencing factors: the shorter the course of disease, the lighter the patient's condition, the higher the degree of cooperation, the better the curative effect of the patient. Conclusion: Acupuncture combined with TDP irradiation has a definite clinical effect on primary dysmenorrhea, which has many advantages, such as good immediate effect, good short-term and long-term curative effect, less adverse clinical reactions, and easy acceptance by patients, etc. This method is worth popularizing in clinic.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R711.51

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